MEDICARE: STEVEN D MACINA DO A PROFESSIONAL MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	20A6625	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528164332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN D MACINA DO A PROFESSIONAL MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	25421 SPINDLEWOOD
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1901
Country	:	US
Telephone Number	:	714-375-2077
Fax Number	:	714-375-2078

Provider Business Practice Location Address
First Line	:	8201 NEWMAN AVE
Second Line	:	SUITE 200
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-7059
Country	:	US
Telephone Number	:	714-375-5405
Fax Number	:	714-375-5408

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN D MACINA
Credential	:	DO
Telephone Number	:	714-484-4900

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	09/28/2009

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